What Is A Nose Job (Rhinoplasty)?

Rhinoplasty or ‘nose job’ is a cosmetic surgery procedure that reshapes the nose, altering the size of the nose to restore balance to the facial features. One of the most popular cosmetic surgery procedures, nose reshaping can completely transform the length, width and shape of your nose and get rid of any lumps and bumps you are unhappy with. Plastic surgery of the nose can also be a corrective procedure for those who have breathing problems, a birth defect or have suffered nose injuries. Although it is quite a complex procedure, the outcome of a rhinoplasty procedure is usually very pleasing.

Am I a Candidate for Rhinoplasty?

Men and women of all ages can be suitable candidates for a nose job. The procedure is not usually performed on children or teenagers under 15 as their nose has not finished growing. An ideal candidate is someone who is unhappy with the way their nose looks but has realistic expectations of what surgery can achieve.

Whether you have always been unhappy with your nose, whether it has changed in size or shape as you are or whether you have some form of deformity as the result of an injury, then a nose job may be right for you.

If you have any of the following concerns, then you may be a suitable candidate for a nose job:

A nose that is too large or too small in comparison with other facial features

A lump or bump on the bridge of the nose

An overly wide nose

A large, droopy, bulbous or protruding tip

Flared or pinched nostrils

A crooked, asymmetrical or misshapen nose

A broken nose or nose that has been injured in an accident

Breathing problems due to nasal structure

If you have broken your nose and the bones have been displaced, then you will need to seek medical attention immediately. In some cases, where the nose has been fractured you can apply ice packs regularly and see the doctor after two or three days after the initial swelling has gone down as this helps the doctor evaluate the damage and make a more accurate assessment of whether or not you may need cosmetic reshaping.

Having realistic expectations is incredibly important when it comes to rhinoplasty surgery. Changing or improving the shape of your nose may give you a lot more confidence but it cannot solve all your problems. Even after surgery your nose may not be perfect however any change in size and shape of the nose can have a dramatic impact on the way your face looks.

The best candidates for a nose job are well adjusted and otherwise happy with their lives.

What Are the Benefits of Rhinoplasty?

Even the slightest change to your nose can have a dramatic effect on the way you look. For the majority of people, a nose job provides very satisfactory results. The most obvious benefit of rhinoplasty is renewed self-confidence in the way you look by improving the aesthetics of your nose.

Having a more symmetrical nose can make you look far more attractive. It is a well-established rule that facial symmetry equals how attractive a person is viewed to be by others. If your nose is off centre or asymmetrical it can make you look less attractive. A nose job can easily correct this and improve the balance of your face.

A large or overly prominent nose can distract from your other facial features and result in teasing or bullying. By changing the size and shape of your nose a rhinoplasty can give your other features a chance to shine. Man y people feel physically and mentally better after having a nose job, especially if their nose has been the subject of ridicule in childhood and adolescence.

There are also a number of functional benefits of nose jobs for those who have suffered from breathing difficulties as a result of the shape of their nose. A nose job can help open up the nasal passages, allowing you to breath more easily. It can also help with birth defects such as cartilage deviation or nasal asymmetry and can alleviate symptoms that may affect the entire circulatory system.

What Are the Risks and Complications with Rhinoplasty?

Like any cosmetic surgery procedure, rhinoplasty involves an element of risk. The major risks of any surgery are post-operative bleeding, infection, and reactions to medications or anesthesia. Having the procedure done under general anesthetic carries an additional risk.

Risks that are specific to nose job surgery include:

Burst blood vessels that can lead to red spots and small scars on the underside of the nose

The need for a re-visionary or secondary procedure

A very small percentage of people may have to have a second minor procedure to achieve the desired results. In many cases this is because they are dissatisfied with the original result. Revision rhinoplasty may also be necessary if the nose is injured in the future.

Temporary loss or reduction in sensitivity to smell (there is a small chance that this could be permanent)

Damage to the septum

There is also a risk that you may develop post-surgery depression, especially if you are not happy with the results of your operation. Because there can be considerable swelling after surgery, it is not easy to tell what the final result will look like for some weeks or even months. It is important to remember that it will take time to fully recover and only then will you be able to see the final result.

What Are the Types of Nose Job (Rhinoplasty)?

There are two main types of nose job surgery: closed rhinoplasty and open rhinoplasty.

Closed Rhinoplasty

This involves having Incisions made inside the nostril, where they will be completely invisible after healing. This type of surgery usually heals quickly and has a faster recovery time. A closed rhinoplasty still allows the surgeon to remove bone and cartilage but it is not suitable when more extensive work is required.

Open Rhinoplasty

This involves a small incision being made between your nostrils as well as inside the nose. This type of surgery allows the surgeon more flexibility and visibility during the procedure but is a more invasive form of surgery and therefore has a longer recovery period and more associated swelling and bruising.

Revision Rhinoplasty

In some cases, you may need to have additional surgery to achieve the desired result or may opt for further surgery if you are dissatisfied with the original outcome. This is known as revision rhinoplasty. You may also need to undergo revision rhinoplasty if your nose is injured or damaged. Secondary rhinoplasty procedures may be more difficult to perform than traditional rhinoplasty surgery if the septum was partly removed or altered during the first procedure. It can also cause problems if the cartilage and bone has been removed, if the skin is thicker and more difficult to work with because of scar tissue or if your airway has been impeded during the initial surgery. The best way to avoid this is to communicate properly with your surgeon during the consultation period and choose a surgeon who is experienced in rhinoplasty surgery.

The Non-Surgical Nose Job

In some in stances it may not be necessary to have surgery. Many cosmetic doctors and nurses now offer a non-surgical alternative to rhinoplasty using dermal fillers. The filler can be used to correct minor deformities in the nose including smoothing out small lumps or dents in the nose and correcting minor asymmetry. While fillers will not be able to correct any major deformities this procedure is a more affordable option for those who only require minor correction and involves very little recovery time. The results can last between 6 and 18 months depending on what type of filler your practitioner uses. Visit our Dermal Fillers section to find out more.

What Happens Before Rhinoplasty Surgery?

Before you decide whether or not to go ahead with rhinoplasty surgery, you will need to book a consultation with a plastic surgeon to find out if the procedure is suitable for you and to ensure you fully understand all the possible risks and complications. Even though it is a cosmetic procedure having a nose job is still major surgery so you will need to ensure you are mentally and physically prepared.

Because changing the appearance of your nose can have such a dramatic impact on your face, the consultation you have with your surgeon is incredibly important. This will give you the opportunity to discuss you goals and hopes for the outcome of the procedure. You will need to be realistic about what can be achieved and listen to your surgeon. If you want Halle Berry’s nose and your surgeon tells you it isn’t possible or will not suit your face, then listen carefully to his/her advice. 3D imaging can be a particularly useful consultation tool for nose job candidates as it allows the surgeon to show you a rough example of what your nose could look like after surgery.

Ask your surgeon to show you before and after pictures of other patients he/she has treated. This will give you an idea of the kind of work they have done. Don’t be afraid to ask them their experience with rhinoplasty. Making sure you have an experienced surgeon will minimize the risk of complications.

During the consultation the surgeon will also take a full medical history to ensure there are not any reasons you cannot undergo surgery. You will also be given a consent form to sign so make sure you read this very carefully and fully understand the procedure before signing it.

Before your surgery you will need to take a couple of precautions. If you are a smoker you will be asked to give up at least two months before your operation. Aspirin and products containing aspirin should be avoided during this time, as they thin the blood and make postoperative bleeding more likely. Make sure you have cold compresses at home to minimize swelling after your surgery and stock up on easy to digest food. On the day of your surgery you should wash your face very thoroughly with an antibacterial wash and avoid eating as this can make you nauseous after surgery.

What Happens During Rhinoplasty Surgery?

Nose jobs are usually performed under general anesthetic although the procedure can be done under local anesthetic or sedation. The operation takes one to two hours and can be carried out at an outpatient’s clinic or hospital. You may be required to stay overnight but in most cases you will be able to go home after a few hours.

The surgeon begins by making an incision either inside the nose or across the skin that separates the nostrils, known as the columella to expose the underlying cartilage and bone. In some cases, the nose is broken and reset alternatively the surgeon ‘shaves’ off or removes cartilage and bone to create the desired shape.

The surgeon then stitches the skin back into place and applies a splint to help the nose retain its new shape. If your nose is not being made smaller, you may only need tape rather than stitches. If stitches are used, they will usually be dissolvable and will not require removal. If the surgeon does make a cut across the skin separating the nostrils, then you will usually have stitches that will need to be removed around a week after surgery.

How your surgery is performed will depend on the type of nose job surgery you are having.

What is The Recovery Following Rhinoplasty?

After your surgery you will be drowsy and unable to drive so make sure you arrange for a friend or relative to pick you up. It is also a good idea to arrange for someone to look after you for a couple of days after surgery as you will need to take it easy and must not exert yourself. It is recommended that you stay in bed and keep your head elevated for at least the first 24 hours after surgery.

Your nose will be sore after your surgery and there will be swelling and bruising. Some people also get black eyes after rhinoplasty surgery. Applying cold compresses around, but not directly on, the nose will help reduce swelling. You may also get some bleeding and should not blow your nose for at least a week. Most of these side effects will go after two or three weeks but it can take several months to completely recover.

Any pain and discomfort can be alleviated with painkillers. Your surgeon may also prescribe you antibiotics which you should take as instructed.

For the first week after your surgery, you should sleep with your head and shoulders raised to keep the swelling and bruising to a minimum and avoid bending over as this can increase blood flow to the nose and increase swelling and post-operative bleeding.

The nasal packing will be removed after a few days, and the splint (which covers the nose after surgery) and/or stitches will be removed one to two weeks later.

Quite often with nose jobs you may look worse than you feel and may want to avoid going out in public until the bruising and swelling has subsided.

You should be able to return to work after a week although you may still be swollen and bruised. You should avoid doing any strenuous activities or playing any contact sports, which may result in your nose being damaged. If you wear glasses will have to have them taped to your forehead or propped on your cheeks for around six to seven weeks following surgery to ensure your nose heals properly.